Partners from national sleeping sickness control programmes of the Democratic Republic of the Congo (DRC), Republic of the Congo and Angola met in Luanda, Angola on 8th to 9th May 2018 to review the progress that has been made in elimination of the disease, also known as human African trypanosomiasis (HAT). Participants from the World Health Organization, which supplies the drugs for treating the disease, also attended.
Of particular interest was Bas-Congo, a transboundary region where the three countries have been implementing a FIND-supported and coordinated project on intensified surveillance and elimination of the disease. This has involved characterization of health facilities, their upgrading and introduction of novel screening and diagnostic tools for HAT.
One of the screening tools is a recently developed rapid diagnostic test (RDT) that is easy to deploy and use in any facility where testing for malaria is done. This means that a person suffering from sleeping sickness is likely to be tested for the disease the first time they seek health care in a public facility. Such early diagnosis is essential before the disease progresses into the brain, and becomes much more difficult to treat.
Laboratory technicians from the three countries have received training in using these novel tests at INRB (Institut National de Recherche Biomédicale) in Kinshasa, supported by experts from Makerere University in Uganda. This experience is a first-rate demonstration of South-South transfer of expertise.
In DRC, the programme started in Kongo Central province in 2014 with the inclusion of 600 participating health facilities. Since then, as absence of disease transmission is demonstrated, the number of health facilities has been gradually scaled-down to only 142 in 2017. The success of the programme has been clearly revealed by a dramatic reduction in new infections.
In Angola, activities started in two provinces in 2016, and despite intensive screening in 50 health facilities, only one case of sleeping sickness was identified in December 2017. In 2018, the programme has been expanded to cover all endemic provinces in the country. Of particular note for Angola is that even before this programme began, their efforts had resulted in a dramatic reduction in the number of reported cases from >8000 in 1997 to only 17 in 2017. With additional efforts on the part of this collaboration, there is optimism that the country is on course to eliminating the disease.
“Many lessons are being learnt through this programme,” said Professor Joseph Ndung’u, Head of FIND’s NTD programme, “including challenges in implementing projects of a transboundary nature, cost-effective ways of maximizing on limited resources as success is demonstrated, and how experiences in one country can be used to the benefit of the other.” In the Republic of the Congo, screening activities were initiated in 54 health facilities in 2016. However, activities were interrupted in early 2017 due to insecurity. In 2018, activities resumed at 40 facilities, and it is anticipated that this country will soon catch up with the others.
All three countries implementing the Bas-Congo project are continuously sharing experiences, harmonizing cross-border activities, and identifying opportunities for capacity building between them. Based on such collaborations, elimination of sleeping sickness in the region is assured.
- Visit our HAT diagnostics implementation page